Parliament Question: RMNCH+A Strategy

GOVERNMENTOFINDIA MINISTRYOFHEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE LOK SABHA UNSTARREDQUESTION NO. 2266 TOBE ANSWERED ON1ST AUGUST,2025 RMNCH+ASTRATEGY 2266 SMT.PRATIMAMONDAL: Will the Minister of HEALTHANDFAMILYWELFARE be pleased tostate: (a) the measures taken by the Government to improve maternal and child health outcomes under the Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A) strategy inthe country; and (b) the details of specific strategies that have been adopted by the Government to strengthen primary healthcare infrastructure under the Ayushman Bharat Health and Wellness Centres andthe mannerinwhich their performance isbeingmonitoredacross Statesinthe country? ANSWER THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND FAMILY WELFARE (SMT. ANUPRIYAPATEL) (a): Under National Health Mission (NHM), various measures/initiatives are undertaken by the Government to improve maternal and child health outcomes under the Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A) strategy in the country, key amongst which are asunder:  Janani Suraksha Yojana (JSY) is a demandpromotion and conditional cash transfer scheme for promotinginstitutional delivery.  JananiShishu SurakshaKaryakram(JSSK) entitlesallpregnantwomen delivering in public health institutions to have free and no-expense delivery, including caesarean section. Theentitlementsinclude freedrugsandconsumables,free dietduring thestay, free diagnostics, free transportation and free blood transfusion, if required. Similar entitlements are also inplace for sick infants.  Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) provides pregnant women a fixed day, free of cost, assured and quality antenatal checkup by a Specialist/Medical Officeronthe 9thdayof every month. Extended PMSMAstrategy focuses on quality antenatal care (ANC) for pregnant women, especially high-risk pregnant (HRP) women and individual HRP tracking with financial incentivization for the identified high-risk pregnant women and accompanying Accredited SocialHealth Activists (ASHAs) for extra 3visits overand above the PMSMAvisit. Surakshit Matritva Aashwasan (SUMAN) aims to provide assured, dignified, respectful and quality healthcare at no cost and zero tolerance for denial of services for every woman and newborn visiting a public health facility, to end all preventable maternalandnewborn deaths.  LaQshya – Quality Improvement Initiative improves the quality of care in labour room and maternity operation theatres to ensure that pregnant women receive respectful andqualitycare during deliveryandimmediatepost-partum.  Optimizing Postnatal Care aims to strengthen the quality of post-natal care by laying emphasis on detection of danger signs in mothers and incentivization of ASHAs for prompt detection, referral & treatment of such high-risk postpartum mothers.  Monthly Village Health, Sanitation and Nutrition Day is an outreach activity at Anganwadi centers for provision of maternal and child care including nutrition in convergence with the IntegratedChild DevelopmentScheme (ICDS).  Birth Waiting Homes (BWH) are established in remote and tribal areas to promote institutional delivery andimprove accesstohealthcarefacilities.  Outreach camps are provisioned to improve the reach of health care services, especially in tribal and hard-to-reach areas. This platform is used to increase awareness for Maternal andChild health services andcommunitymobilizationaswell astotrackhigh-risk pregnancies.  Under Facility Based Newborn Care, Special New-born Care Units (SNCUs) are established at District Hospital and Medical College level, Newborn Stabilization Units (NBSUs) are established at First Referral Units (FRUs)/ Community Health Centres(CHCs) for care of sick andsmall babies.  Under Community Based care of Newborn and Young Children, Home Based New-born Care (HBNC) andHome-Based Care of Young Children(HBYC) programs are in place under which, home visits are performed by ASHAs to improve child- rearingpracticesandto identifysick newborn andyoungchildreninthe community.  Social Awareness and Actions to Neutralize Pneumonia Successfully (SAANS) initiative is implemented since 2019 for the reduction of childhood morbidity and mortalitydue toPneumonia.  STOP Diarrhoea campaign is implemented for promoting use of ORS and Zinc and for reducingmorbidityandmortality due tochildhooddiarrhoea.  Under Rashtriya Bal SwasthyaKaryakram (RBSK),Childrenfrom 0to18yearsof age are screened for 32 health conditions (i.e.Diseases, Deficiencies, Defects and Developmental delay) to improve child survival. District Early Intervention Centres (DEICs) are established at the district health facility level for confirmation andmanagementof children screenedunderRBSK.  Mothers’ Absolute Affection (MAA) Program is implemented to promote breastfeeding practices, emphasizing the importance of early initiation of breastfeedingandexclusive breastfeedingfor first six months.  Anemia Mukt Bharat (AMB) strategy is implemented to reduce anemia among six beneficiaryage groups - children (6-59 months), children(5-9 years), adolescents(10- 19 years), pregnant and lactating women and women of reproductive age group (15-49 years) in life cycle approach through implementation of six interventions via robust institutional mechanisms.  Nutrition Rehabilitation centres (NRCs) are set up at public health facilities to provide in-patient medical and nutritional care to children under 5 years suffering from SevereAcute Malnourishment (SAM) with medicalcomplications.  Comprehensive Lactation Management Centres(CLMC) are established to ensure availability of safe, pasteurized Donor Human Milk for feeding of sick, preterm and low birth weight babies admitted in Neonatal Intensive Care Units and Special Newborn Care Units.  Rashtriya Kishor Swasthya Karyakram (RKSK) is implemented in all States/UTs to ensure holistic development of the adolescent population which includes intervention of peer education programme, weekly Iron folic acid supplementation, Scheme for Promotion of Menstrual Hygiene among adolescent girls and Adolescent FriendlyHealthClinics (AFHCs).  School Health & Wellness Programme (AB-SHWP) is implemented as a joint initiative of Ministry of Health and Family Welfare and Ministry of Education under which Two teachers, preferably one male and one female, in every school are designatedas“HealthandWellness Ambassadors” (HWAs)for Health Promotion.  Expanded Contraceptive Choices comprising of Condoms, Combined Oral contraceptive pills, Intrauterine Contraceptive Devices (IUCD), Sterilization, Injectable contraceptive MPA (Antara Programme), Centchroman (Chhaya) and Emergency contraceptivepillsare providedtobeneficiaries.  Mission Parivar Vikas is implemented in thirteen states for increasing access to contraceptivesandfamily planningservices.  Compensation scheme for Sterilization acceptors provides compensation for loss of wagestothe beneficiaries for Sterilization.  Post-Pregnancy contraception in the form of Post-Partum Intrauterine Contraceptive Device (PPIUCD), Post-Abortion Intrauterine Contraceptive Device (PAIUCD), andPost-PartumSterilization (PPS)are providedtobeneficiaries.  ‘World Population Day Campaign’ and ‘Vasectomy Fortnight’ are observed every year to boost awareness on Family Planning and service delivery across all States/Union Territories.  Home Deliveryof Contraceptive Schemeisimplementedthrough ASHAs.  Family Planning Logistics Management Information System (FPLMIS) is implemented toensure availability of Family Planning commoditiesacross alllevels of healthfacilities. (b): The National Health Mission (NHM) provides support for strengthening health infrastructure and ensuring the availability of adequate human resources across health facilities, to improve availability and accessibility to quality health care, especially for the underserved and marginalized groups in rural areas. The Ministry of Health and Family Welfare (MoHFW) provides both technical and financial assistance to the States and UTs tostrengthen the public healthcare system, including strengthening of the health workforce based on the proposals received under the National Health Mission as per norms and availableresources. As on 24th July 2025, total of 1,78,342 Ayushman Arogya Mandirs have been operationalized, by transforming existing Sub-Health Centres (SHC) and Primary Health Centres (PHC) in rural and urban areas to deliver the expanded range of comprehensive primary healthcare services that includes preventive, promotive, curative, palliative and rehabilitative services which are universal, free,andcloser tothe community. The PradhanMantri - AyushmanBharat HealthInfrastructure Mission (PMABHIM) develops capacities of primary, secondary, and tertiary care Health Systems, strengthen existing national institutions, and creates new institutions to fill gaps in public health infrastructure. The 15th Finance Commission supports local government for strengthening the primary healthinfrastructure in rural andurbanareas. Under the National HealthMission (NHM), the performance of varioushealthprogrammes is regularly assessed through review meetings, video conferences and field visits of senior officials, promoting performance by setting up benchmarks for service delivery and rewarding achievements, etc. Additionally, the functioning of NHM is periodically evaluated through externalsurveys, such asthe National Family HealthSurvey(NFHS) andthe Sample Registration System (SRS). Further, Common Review Missions (CRMs) are conducted annuallyunder NHM toassess andmonitorthe implementationstatus and progress of various healthschemesincluding the AyushmanArogya Mandir. *****